Bootcamp Clone of Personal Tax Client Intake Form

Personal Information
Legal Name (as per CRA mailing/ records)*
Date of Birth*

MonthDayYear
SIN*
Gender*

Contact Information
Current Address*
Preferred Contact Phone Number*
Please enter a valid phone number.
Current Email Address*
example@example.com

Spouse/Partner Information
What is your current marital status?*
Spouse/Partner Legal Name*
Spouse/Partner Date of Birth*

MonthDayYear
Spouse/Partner SIN*
Is Spouse / Partner information being submitted to us?*
If not, what is your Spouse / Partners net income (line 150)*
Has your marital status changed during the tax year?*
What did your marital status change to?*
What is the effective date of this change?*

MonthDayYear
Date
Spouse/Partner Legal Name*
Spouse/Partner Date of Birth*

MonthDayYear
Spouse/Partner SIN*
Is Spouse / Partner information being submitted to us?*
If not, what is your Spouse / Partners net income (line 150)*
Child/Dependant Information
Do you have any children/dependants?*
How many children/dependants do you have to claim?*
Child/Dependant # 1*
Child/Dependant # 2*
Child/Dependant # 3*
Child/Dependant # 4*
Child/Dependant # 5*
Child/Dependant # 6*
Child/Dependant # 7*
Child/Dependant # 8*
Do you have any new children/dependants to report?*
How many new children/dependants to report?*
New Child/Dependant # 1*
New Child/Dependant # 2*
New Child/Dependant # 3*
New Child/Dependant # 4*
Have any of your existing children/dependants...*
Please provide all details - child/depenant name, income earned, tuition transfer (need signed T2202), DTC

Residency & Filing
Canadian Citizen?*
Residency Status*
Provide Information to Elections Canada?*
Did you sell a home during the tax year(s) we are preparing for you?*
Was this home your primary residence for the full time you owned it?*
Did you rent any part of the home out during any of the years you owned it.*
Details of property sold...*
Did you own Foreign Property (real property, investments) of more than $100k CAD in value?*
Do you have a valid T2201 Disability Tax Credit approved on file with CRA?*

Income
Tax Checklist - Income

Please ensure to gather to upload all income slips including but not limited to...
- All T4 slips
- Investment income slips – Such as T5, T3, T4RSP, T4RIF, T4PS, T5008
- Pensions – Old Age Security T4A(OAS), Canada Pension T4AP, other pensions, and annuities T4A.
- Employment Insurance Benefits – T4E
- Social Assistance / Workers Compensation Payments T5007, T5008
- Self-Employment / Business Activities - Worksheet required
- Self-Employment / Commission Activities - Worksheet required
- Rental Income - Worksheet required
Are you submitting any of the above mentioned income tax slips*

Deductions
Tax Checklist - Deductions

Please ensure to gather to upload all income slips including but not limited to...
- Childcare – with supporting receipts and SIN of the caregiver
- Adoption costs
- Tuition Receipts – T2202 (Note - no other receipts for school expenses are deductable)
- RRSP Contributions (for Mar - Dec of the current tax year or 1st 60 days of the subsequent year)
- Child or Spousal Support – with a copy of the agreement if not previously provided
- Rent / Property Tax - Ontario Only
- Professional Fees or Union Dues (not included on T4)
- Medical Expenses - Worksheet required for more than 5 slips
- Charitable Donations (not included on T4)
- Interest on Student Loans
- Political Contributions
- Tool Expenses - Employment Expenses worksheet required - provided
- Moving Expenses – only if moving for work/school - worksheet required - provided
- Employment Expenses - worksheet required
- Carrying charges and interest expenses (Safety Deposit Box or interest on investment loan)
- Rent receipt
- Custody agreement
Are you submitting any of the above mentioned deduction receipts*

Additional forms...

Medical Expenses over 5 receipts, Moving Expenses, Employment Expenses accompanying T2200, Rental Income, Self-employed Income.
You did not select any of these options. Please continue.
Medical Expenses
Total Medical Expenses*
Medical Insurance

*for Quebec residents only
Medical Insurance Coverage

Private Medical Insurance - through employerPrivate Medical Insurance - I have my own planI Don’t Have Private Medical Insurance - RAMQ
If you have your own plan, how much are your monthly premiums?
Employment Expenses

MUST be accompanied by a statement of conditions of employment (T2200) provided by your employer. You need to keep all supporting receipts and documents in case of CRA review.
Expenses...
Other expenses that do not fit in any of the above categories (Specify description and amounts below) - NOTE: Any individual items over $200 must be itemized in the CCA/Fixed Asset chart
CCA/Fixed Assets acquired and disposed of. (All depreciable property over $200 in value including business furniture, office equipment etc.)
Do you have a home office that your employer allows you to deduct - (Must specify on T2200 from employer)*
Home office expenses...
Other expenses that do not fit in any of the above categories. Specify descriptions and amounts below.
Do you receive commissions reported on your T4?*
Commission Employees Only - Also Complete Property Taxes and Home Insurance Below
Property Taxes
Home Insurance
Do you have any motor vehicle expenses to deduct? You must keep all receipts and mileage log for 6 years for CRA. (Must specify on T2200 from employer)*
Motor Vehicle Expenses...
Is vehicle financed or leased?*
If Financed...*
If Leased...*
Real Estate Activities
Do you have more than 1 rental property?*
How many rental properties do you own?*
Rental Property # 1...
Rental Property # 2...
Rental Property # 3...
Rental Property # 4...
Rental Property # 5...
Home Office Expenses...
Motor Vehicle Expenses...
Is vehicle financed or leased?
If Financed...*
If Leased...*
Self-Employed Activities

You are required to keep all supporting documents in case of a CRA review.
Business details...
Income and Earnings (Less GST/HST if you are HST registered)
Cost of Goods Sold...
Expenses (Less GST/HST if you are GST/HST registered)
Other expenses that do not fit in any of the above categories (Specify description and amounts below) - NOTE: Any individual items over $200 must be itemized in the CCA/Fixed Asset chart
CCA/Fixed Assets acquired and disposed of. (All depreciable property over $200 in value including business furniture, office equipment etc.)
Home Office Expenses...
Motor Vehicle Expenses...
Is vehicle financed or leased?
If Financed...*
If Leased...*

Document Uploads

Scan ALL your tax receipts, documents & receipts and then upload them below. Multiple files can be uploaded at once. You may take photos to upload, however you will need to ensure the photo is clear for viewing.
Are you providing us with your banking information for CRA to deposit any refunds? If so, please upload a picture of a void cheque. If you are already set up with direct deposit please select no.*
Document Upload - Please upload ALL tax documents using the window below.

Cancelof
Do you see all documents you uploaded in a list below the Browse Files window above? If not, please wait a moment or upload again.*
Do you have any additional notes or comments regarding your income taxes for us?*
I declare that all information provided in this submission is complete and accurate. I also declare that I have supporting documents and receipts as required by CRA and that it is MY responsibility to keep these documents in case of CRA review for a minimum of 6 years from the date of this filing. I understand that Amselem Tax Services is completing my return based on the information provided by myself. *
Signature*

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Personal Tax Client Intake Form

Personal Information

Contact Information

Spouse/Partner Information

Child/Dependant Information

Residency & Filing

Income

Deductions

Additional forms...

Medical Expenses

Medical Insurance

Employment Expenses

Real Estate Activities

Self-Employed Activities

Document Uploads

Review